In 2010, Margaret Hogan and colleagues1 credited Italy with the lowest maternal mortality ratio (MMR) in the world. Despite reporting a 63% underestimation of MMR,2 the figure of four maternal deaths per 100 000 livebirths was again published in 2014 in an Article by Kassebaum and colleagues,3 to which we replied,4 as well as by recent WHO estimates published by Leontine Alkema and colleagues in The Lancet.5